Shimizu Ken, Nakaya Naoki, Saito-Nakaya Kumi, Akechi Tatsuo, Ogawa Asao, Fujisawa Daisuke, Sone Toshimasa, Yoshiuchi Kazuhiro, Goto Koichi, Iwasaki Motoki, Tsugane Shoichiro, Uchitomi Yosuke
Psycho-Oncology Division, National Cancer Center Hospital, Tokyo
Division of Personalized Prevention and Epidemiology, Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Miyagi.
Jpn J Clin Oncol. 2015 May;45(5):456-63. doi: 10.1093/jjco/hyv024. Epub 2015 Mar 10.
Although various factors thought to be correlated with anxiety in cancer patients, relative importance of each factors were unknown. We tested our hypothesis that personality traits and coping styles explain anxiety in lung cancer patients to a greater extent than other factors.
A total of 1334 consecutively recruited lung cancer patients were selected, and data on cancer-related variables, demographic characteristics, health behaviors, physical symptoms and psychological factors consisting of personality traits and coping styles were obtained. The participants were divided into groups with or without a significant anxiety using the Hospital Anxiety and Depression Scale-Anxiety, and a binary logistic regression analysis was used to identify factors correlated with significant anxiety using a multivariate model.
Among the recruited patients, 440 (33.0%) had significant anxiety. The binary logistic regression analysis revealed a coefficient of determination (overall R(2)) of 39.0%, and the explanation for psychological factors was much higher (30.7%) than those for cancer-related variables (1.1%), demographic characteristics (2.1%), health behaviors (0.8%) and physical symptoms (4.3%). Four specific factors remained significant in a multivariate model. A neurotic personality trait, a coping style of helplessness/hopelessness, and a female sex were positively correlated with significant anxiety, while a coping style of fatalism was negatively correlated.
Our hypothesis was supported, and anxiety was strongly linked with personality trait and coping style. As a clinical implication, the use of screening instruments to identify these factors and intervention for psychological crisis may be needed.
尽管多种因素被认为与癌症患者的焦虑相关，但各因素的相对重要性尚不清楚。我们检验了这样一个假设，即人格特质和应对方式比其他因素能更大程度地解释肺癌患者的焦虑。
共选取了1334例连续招募的肺癌患者，获取了与癌症相关变量、人口统计学特征、健康行为、身体症状以及由人格特质和应对方式组成的心理因素的数据。使用医院焦虑抑郁量表-焦虑分量表将参与者分为有或无显著焦虑的组，并采用二元逻辑回归分析，通过多变量模型确定与显著焦虑相关的因素。
在所招募的患者中，440例（33.0%）有显著焦虑。二元逻辑回归分析显示决定系数（总体R²）为39.0%，心理因素的解释率（30.7%）远高于癌症相关变量（1.1%）、人口统计学特征（2.1%）、健康行为（0.8%）和身体症状（4.3%）。四个特定因素在多变量模型中仍具有显著性。神经质人格特质、无助/绝望的应对方式和女性性别与显著焦虑呈正相关，而宿命论的应对方式与显著焦虑呈负相关。
我们的假设得到了支持，焦虑与人格特质和应对方式密切相关。作为临床启示，可能需要使用筛查工具来识别这些因素并对心理危机进行干预。
